Guidelines Updated for Adult Congenital Heart Disease

THURSDAY, Sept. 27, 2018 — Updated guidelines have been developed for management of adult congenital heart disease (ACHD), according to a report published online Aug. 16 in Circulation.

Karen K. Stout, M.D., from the University of Washington in Seattle, and colleagues developed guidelines for the management of ACHD patients. Because of the success of treating patients during their childhood, the prevalence of ACHD is increasing, with survival to age 18 years expected for 90 percent of children diagnosed with severe CHD.

The authors provide new ACHD classification system, which is intended to capture the complexity of ACHD anatomy and physiology; classification should be based on the “highest” relevant anatomic or physiologic feature. Patients may move from one classification to another over time. For patients with complex CHD, outcomes are generally better when patients are cared for in integrated, collaborative, and multidisciplinary programs. Continued access to specialized care presents challenges as patients grow beyond the pediatric age group; these include lack of guided transfer from pediatric to adult care, insufficient availability of ACHD programs, inadequate insurance cover, lack of education of patients and caregivers regarding ACHD, and lack of comprehensive case management.

“Patients with ACHD are a heterogeneous population,” Stout said in a statement. “Although the prevalence of ACHD is increasing, the population of patients with a given congenital abnormality or specific repair may be relatively small, which can make accruing evidence to guide treatment challenging.”

Several writing committee members disclosed financial ties to the pharmaceutical and medical device industries.

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Posted: September 2018

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